| NPI | 1225611924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN26551) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN26651) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 122300000X Dentist (Licence: HI DT2908) | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2025-02-03 |