| NPI | 1053971861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0401416503) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401416503) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC DGD.10440) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: VA 0401416503) | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2023-08-22 |