| NPI | 1346897923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30682) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D14273) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2024-06-10 |