| NPI | 1649711417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24478) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 3317) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2019-10-04 |