| NPI | 1265167506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA PA62020) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA PA62020) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2025-01-15 |