| NPI | 1821313784 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX Q8191) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD 448777) | 
| Enumeration Date | 2010-04-05 | 
| Last Update Date | 2016-10-31 |