| NPI | 1710064357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N3704) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX N3704) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-02-11 |