| NPI | 1336562073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 63789) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2025-01-29 |