| NPI | 1083022297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T5182) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 305581) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2025-03-31 |