| NPI | 1639703408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn27284) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DRPM2148) |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2022-07-18 |