| NPI | 1003560137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 7337) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 7337) |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2024-05-15 |