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 |