NPI | 1639100902 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OR MD126297) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA G65750) |
2080S0010X Pediatrics, Sports Medicine (Licence: CA G65750) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2014-02-13 |