| NPI | 1558345280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NC 101507) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 101507) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2008-05-23 |