| NPI | 1801472683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: CO DR.0074555) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD.MD.61522354) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2025-07-08 |