| NPI | 1073013025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 6001396) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D14292) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30533) | |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2024-02-06 |