| NPI | 1447563143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 8214) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: TN DS0000009206) | |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2013-08-26 |