| NPI | 1306406475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U4796) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151013919) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2023-07-05 |