| NPI | 1093955254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 6403-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6403-015) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-03-01 |
| Last Update Date | 2023-07-09 |