| NPI | 1780974709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD455072) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME128399) |
| 208000000X Pediatrics (Licence: DE C1-0012070) | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: DE C1-0012070) | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: PA MD455072) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2018-03-17 |