| NPI | 1598388498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 108213) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 37806) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 244202) | |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2022-12-29 |