| NPI | 1821432584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S9854) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: TX S9854) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2022-10-03 |