| NPI | 1861793192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME129301) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 12698) |
| 208000000X Pediatrics (Licence: FL ME129301) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2016-11-04 |