| NPI | 1689915084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D10445) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9856) |
| 122300000X Dentist (Licence: PR 3394) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-09 |
| Last Update Date | 2024-02-25 |