| NPI | 1346869021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D11306) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: OR D11306) | |
| 1223G0001X Dentist, General Practice (Licence: OR D11306) | |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2022-08-11 |