| NPI | 1255695573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: CO DR0055233) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012017894) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2016-08-03 |