| NPI | 1649065442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0442000554) |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-07-03 |