| NPI | 1659857472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 14083) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 00203695) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-15 |
| Last Update Date | 2024-06-18 |