| NPI | 1225659352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 1002342-15) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: WI 1002342) | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2025-09-26 |