| NPI | 1598400038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN28953) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN123235) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 13396) | |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2024-09-11 |