| NPI | 1720827934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 8068) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00206047) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2025-04-07 |