| NPI | 1770112435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC 93608) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 5115) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2025-06-15 |