| NPI | 1316487531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN24480) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN24480) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2022-07-01 |