| NPI | 1669656849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 43516) |
| Additional Taxonomies | 2080S0010X Pediatrics Sports Medicine (Licence: KY 43516) |
| Enumeration Date | 2007-12-23 |
| Last Update Date | 2024-02-14 |