| NPI | 1518318260 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OK 34512)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 33707)  | 
| Enumeration Date | 2016-06-23 | 
| Last Update Date | 2025-04-15 |