NPI | 1538694740 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 306951) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-04-25 |
Last Update Date | 2022-11-01 |