| NPI | 1063765196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: RI 07468) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI 07468) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2012-10-26 |