| NPI | 1013573336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 17331) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WI 1002094-15) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2021-04-27 |