| NPI | 1902483795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD226076) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: OR MD226076) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-07-25 |