| NPI | 1659629095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME174328) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 276973) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2025-06-23 |