| NPI | 1356964217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA DS044715) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CO DEN.00205306) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2024-06-26 |