| NPI | 1730821802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX BP10079507) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2025-0200) |
| Enumeration Date | 2022-04-10 |
| Last Update Date | 2025-02-27 |