| NPI | 1649652793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health (Licence: TX 37298) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 37298) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2024-01-23 |