| NPI | 1164202685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 13691) |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2024-06-06 |