| NPI | 1518669498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10985) |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2025-08-13 |