| NPI | 1467210922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30712) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 2024-234A) |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2025-07-16 |