| NPI | 1558055905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA S-1207) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC DGD.10525) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2024-12-04 |