| NPI | 1700311883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: SC 9123) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NC 12185) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2023-08-07 |