| NPI | 1093147217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S9223) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD458728) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2021-11-02 |