| NPI | 1619538683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA PA60972448) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-10-02 |