| NPI | 1205158169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME109241) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 253913) |
| 208000000X Pediatrics (Licence: NY 253913) | |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2012-02-13 |