| NPI | 1366007601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: VA 0401416920) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 390200000X) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2023-02-20 |