| NPI | 1629364021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 76313) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301099007) |
| 208000000X Pediatrics (Licence: MN 4301099007) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301099007) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2019-10-13 |