| NPI | 1619361151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NJ 25MA11206600) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA11206600) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-04-11 |