| NPI | 1295477313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM TD-00-161) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 39239) |
| Enumeration Date | 2022-04-09 |
| Last Update Date | 2023-05-12 |