| NPI | 1730742438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist Dentist Anesthesiologist (Licence: PA DA031882) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS043506) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2022-11-29 |