| NPI | 1548647183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: PA OS021248) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT016506) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2021-09-13 |