| NPI | 1982642559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 153377) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 153377) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 153377) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2015-08-27 |