| NPI | 1225607104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2951000998) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204801) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2025-07-09 |