| NPI | 1679519862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics Sports Medicine (Licence: PA MD056638L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD056638L) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2016-07-14 |