| NPI | 1891895777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: GA 58543) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 58543) |
| 208000000X Pediatrics (Licence: GA 58543) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-10-28 |