| NPI | 1124360755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME150831) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 57.245816) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2024-08-20 |