| NPI | 1497985915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: VA 0401412666) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2022-02-23 |