| NPI | 1255917027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 321277) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX V7195) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2025-05-10 |