| NPI | 1457557761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME116025) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT190034) |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2015-01-21 |