| NPI | 1558948760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MO 2024025625) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: KS 05-49653) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: CO 0010575) | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-07-21 |