| NPI | 1528650710 |
|---|---|
| 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: VA 0401418721) |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: VA 0401418721) | |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2024-04-29 |