| NPI | 1205099645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health (Licence: MO 2013030815) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2016-01-28 |