| NPI | 1760018675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A186618) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A186618) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2024-10-31 |