| NPI | 1790084796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: MA 247434) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 247434) |
| 207K00000X Allergy & Immunology (Licence: MA 247434) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2015-08-13 |