| NPI | 1215559745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 12192582-9924) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 12192582-9921) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2022-05-02 |