| NPI | 1609515899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 14074) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC DGD.10215) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2024-06-11 |