| NPI | 1477049617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2023028005) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001906) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2024-02-20 |