| NPI | 1629276092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R8166) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 13619) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV LL1779) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2024-03-04 |