| NPI | 1023442316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30629) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI CDEN03251) |
| 122300000X Dentist (Licence: IL 019030062) | |
| 1223G0001X Dentist, General Practice (Licence: MA DN1856378) | |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2022-07-21 |