| NPI | 1750458360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NY 110525-1) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 110525-1) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2025-09-11 |