| NPI | 1073042669 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA DDS-09406)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09406)  | 
| 1223D0001X Dentist, Dental Public Health (Licence: IA DDS-09406)  | |
| 1223E0200X Dentist, Endodontics (Licence: IA DDS-09406)  | |
| 1223G0001X Dentist, General Practice (Licence: IA DDS-09406)  | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IA DDS-09406)  | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: IA DDS-09406)  | |
| 1223P0300X Dentist, Periodontics (Licence: IA DDS-09406)  | |
| 1223P0700X Dentist, Prosthodontics (Licence: IA DDS-09406)  | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA DDS-09406)  | |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: IA DDS-09406)  | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA DDS-09406)  | |
| Enumeration Date | 2017-06-07 | 
| Last Update Date | 2017-06-07 |