| NPI | 1700015559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: NY 280861-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125057017) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: NY 280861-1) | |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2022-01-04 |