| NPI | 1760474431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD032900E) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA05556600) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2007-07-08 |