| NPI | 1427445295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901022449) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX ETN314) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX ETN314) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2021-09-01 |