| NPI | 1386226413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38082) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.033321) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2022-03-03 |