| NPI | 1326524133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OR D11222) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MT DEN-DEN-LIC-23530) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 1577) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD D1291) | |
| Enumeration Date | 2018-07-15 |
| Last Update Date | 2023-10-12 |