| NPI | 1558120519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D15342) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: WA DR61546849) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2025-06-24 |