| NPI | 1255863189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 58345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 66667) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 1.065711-RES) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-07-11 |