| NPI | 1073060596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 40795) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22232) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN22232) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DN22232) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2024-07-17 |