| NPI | 1689871576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MI 4301090364) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301090364) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2025-11-06 |