| NPI | 1134743958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901602392) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002316-15) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2025-02-10 |