| NPI | 1386223980 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V2503) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2021-04-02 | 
| Last Update Date | 2024-07-31 |