| NPI | 1720189632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MI 4301086674) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301086674) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-10-22 |