| NPI | 1275987190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 16730) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101948) |
| 122300000X Dentist (Licence: FL 25626) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2024-04-30 |