| NPI | 1912353921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: MA 1014545) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 62452) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2023-04-24 |