| NPI | 1548676596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PR 13542) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 13542) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 19679) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2021-08-05 |