| NPI | 1609216092 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 35.136646) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 57914) | 
| 208000000X Pediatrics (Licence: IA R-9775) | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CT 57914) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-28 | 
| Last Update Date | 2021-07-30 |