| NPI | 1609093871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR MD161718) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MO 2010005854) |
| 207K00000X Allergy & Immunology (Licence: WA MD60341389) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2013-07-31 |