| NPI | 1588191803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN24350) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH RES.003826) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-04-25 |