| NPI | 1265015168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 7561) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7516) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV 390200000X) | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-09-23 |