| NPI | 1215369673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DRPM3054) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60384466) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2026-09-02 |