NPI | 1770782377 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: WA MD60156323) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: CA A107963) |
Enumeration Date | 2007-07-13 |
Last Update Date | 2019-03-06 |