| NPI | 1639809262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 10004) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 10004) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-06-20 |