| NPI | 1083037931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 1002714-15) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MN D13365) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2025-06-03 |