| NPI | 1154989788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 14211589-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 65867) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2025-04-08 |