| NPI | 1639973449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DN30493) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN30493) |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2025-09-26 |