| NPI | 1033524509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 24559) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX ETN263) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-08-03 |