| NPI | 1265972293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: WA DE60812299) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: WA DR60753961) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2018-02-07 |