| NPI | 1245800333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT 25907) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002640-15) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2023-07-10 |