| NPI | 1750841284 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: PA Os023164)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS023164)  | 
| Enumeration Date | 2019-03-21 | 
| Last Update Date | 2024-12-18 |