| NPI | 1619039781 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 35142) | 
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: KY 35142) | 
| Enumeration Date | 2006-12-15 | 
| Last Update Date | 2011-11-10 |