| 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 |