| NPI | 1144563560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DN122551) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 057724) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2024-10-11 |