| NPI | 1710362512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NJ 25MA12240100) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MO 2018031089) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2025-01-13 |