| NPI | 1659001949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC DGD.10212) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC DGD.10212) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2023-06-30 |