| NPI | 1235424771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2025-0855) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 2025-00855) |
| 208D00000X General Practice (Licence: CA A145699) | |
| 207K00000X Allergy & Immunology (Licence: CA A145699) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2025-11-08 |