| NPI | 1235979451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2901602066) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901602066) |
| Enumeration Date | 2024-05-27 |
| Last Update Date | 2024-06-17 |