| NPI | 1689258220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401417640) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN2000061) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2024-11-07 |