| NPI | 1467718569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: UT 9376004-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 9376004-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0006943) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2022-03-11 |