| NPI | 1033789987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30677) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019.033114) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2024-05-14 |