| NPI | 1972706661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA 200951) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 64658) |
| 208000000X Pediatrics (Licence: DC MD036381) | |
| 208000000X Pediatrics (Licence: LA 200951) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2014-08-25 |