| NPI | 1366184103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V8604) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2025-09-23 |