| NPI | 1538780390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 61158728) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 390200000X) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2024-08-05 |