| NPI | 1548752496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 72349) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: MN 72349) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-08-19 |