| NPI | 1063073898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA DDS-09997) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 30568) |
| 122300000X Dentist (Licence: IA DDS-09997) | |
| 1223G0001X Dentist, General Practice (Licence: IA DDS-09997) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2022-07-26 |