| NPI | 1891292108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T1312) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX T1312) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2022-12-09 |