| NPI | 1295265767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA 61047546) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP03934) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2020-06-22 |