| NPI | 1255904082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30681) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.033249) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2024-05-21 |