| NPI | 1679153431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN28248) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DRP2288) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2024-08-01 |