| NPI | 1710956040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 184622) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 184622) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2013-03-26 |