NPI | 1306543525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX PA16898) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA16898) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-02-08 |
Last Update Date | 2024-05-22 |