| NPI | 1215498506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V9219) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX V9219) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-07-14 |