| NPI | 1235581562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.026017) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2021-12-22 |