| NPI | 1205193919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q4353) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 09600287) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2023-02-14 |