NPI | 1912292624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: DE C1-0012153) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD P26318) |
2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NJ 25MA10076900) | |
Enumeration Date | 2011-06-10 |
Last Update Date | 2018-03-17 |