| NPI | 1295672673 |
|---|---|
| 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: MI 2951001034) |
| Enumeration Date | 2026-05-02 |
| Last Update Date | 2026-07-09 |