| NPI | 1275813644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S7787) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 281582) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2020-10-08 |