| NPI | 1093158594 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S0942) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2016-00622) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-15 | 
| Last Update Date | 2024-12-13 |