| NPI | 1235755935 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 18256) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN25412) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-19 | 
| Last Update Date | 2024-12-27 |