| NPI | 1740785005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: IL 036167084) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 287319) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-04-19 |