| NPI | 1760879381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U0219) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A154065) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10052452) | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2022-10-11 |