| NPI | 1154946051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013361A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2951000814) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2021-08-16 |