| NPI | 1528333473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA DDS-09153) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 09153) |
| 1223G0001X Dentist, General Practice (Licence: IL 019-029329) | |
| Enumeration Date | 2012-03-11 |
| Last Update Date | 2021-09-01 |