| NPI | 1588396360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401418052) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2022-07-25 |