| NPI | 1336887504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61404962) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2023-05-29 |