| NPI | 1396430591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 13782) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 14264) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2025-04-16 |