| NPI | 1164640892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA10934900) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD472089) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2021-01-21 |