| NPI | 1346860434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA DDS-09982) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30582) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2022-07-13 |