| NPI | 1700324688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33950) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33950) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2021-09-09 |