| NPI | 1700315587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S7277) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN24927) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2021-01-06 |