| NPI | 1649623281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 4145) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040993) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2020-01-24 |