| NPI | 1831720903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 283657) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ZZ 41268) |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2021-07-09 |