| NPI | 1457618639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OR D9975) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR 390200000) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2022-10-12 |