| NPI | 1891875522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: NC 2011-00001) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: DC MD034832) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: CA A105742) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-07-29 |