| NPI | 1780683961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: WV 17589) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WV 17589) |
| 208000000X Pediatrics (Licence: WV 17589) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2015-06-22 |