| NPI | 1649809450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 17428) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD LL866) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2022-10-25 |