| NPI | 1629555214 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 122300000X Dentist (Licence: TX 34281)  | 
| Enumeration Date | 2018-07-26 | 
| Last Update Date | 2025-05-21 |