| NPI | 1265960280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NE 31201) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2024-03-22 |