| NPI | 1649701863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 283009) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: RI MD17963) |
| 208000000X Pediatrics (Licence: RI MD17963) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2026-03-13 |