| NPI | 1336689769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WI 1002028-15) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 30492) |
| Enumeration Date | 2017-03-04 |
| Last Update Date | 2022-02-17 |