| NPI | 1053542357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 66160) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301094849) |
| 208000000X Pediatrics (Licence: WI 73359) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MI 4301094849) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2020-08-20 |