| NPI | 1881263192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V5985) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME166588) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10076296) | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-04-28 |