| NPI | 1225520166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH RES.004334) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.031575) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2021-06-09 |