| NPI | 1851706295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD60966216) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014020169) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2019-08-30 |