| NPI | 1265842926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 34403) |
| Enumeration Date | 2014-05-04 |
| Last Update Date | 2023-06-01 |