| NPI | 1578195111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS043100) |
| 1223G0001X Dentist General Practice (Licence: WV 4675) | |
| 1223G0001X Dentist General Practice (Licence: VA 0401418318) | |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2024-07-17 |