| NPI | 1649530395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME130207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN17336) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MA 269327) | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2019-03-22 |