| NPI | 1134819329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: Y3144508) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA Y3144508) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-05-18 |