| NPI | 1326684499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0442000486) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS105812) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2023-06-26 |