NPI | 1588084347 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: PA MD474504) |
Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: NY 288147) |
2080S0010X Pediatrics, Sports Medicine (Licence: DE C1-0024352) | |
Enumeration Date | 2014-04-21 |
Last Update Date | 2021-08-05 |