| NPI | 1972706661 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA 200951)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 200951)  | 
| 208000000X Pediatrics (Licence: DC MD036381)  | |
| 207K00000X Allergy & Immunology (Licence: GA 64658)  | |
| Enumeration Date | 2007-06-08 | 
| Last Update Date | 2025-10-06 |