| NPI | 1639637507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015901) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA DN015901) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2024-12-19 |