| NPI | 1104051721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MN 108249) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-40199) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2015-07-08 |