| NPI | 1306125125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA MD60706294) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 262141) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2018-05-30 |