| NPI | 1295369338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN016158) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN016158-T) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DN25496) | |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2021-08-11 |