| NPI | 1568925428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS043066) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 00000000) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2021-04-21 |