| NPI | 1063143519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: SC 11146) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: SC 11146) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2026-02-16 |