| NPI | 1790005692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO CDRH.56391) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 34-010925) |
| 208000000X Pediatrics (Licence: OH 34-010925) | |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: OH 34-010925) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2021-06-22 |