| NPI | 1194475491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 110011) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.034171) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2024-04-10 |