| NPI | 1902907900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA c56115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA c56115) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: CA c56115) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-17 |