| NPI | 1194307520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS044545) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM TD-00-139) |
| 1223G0001X Dentist, General Practice (Licence: NM DD5576) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-10-08 |