| NPI | 1487409835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2025027653) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.035087) |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2025-07-07 |