| NPI | 1306040415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N9063) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 44196) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-09-23 |