NPI | 1144517103 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OK 32856) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10039679) |
Enumeration Date | 2011-06-28 |
Last Update Date | 2023-08-28 |