| NPI | 1790703023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MD D68780) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NC 2005-01555) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-11-10 |