| NPI | 1740745728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA DDS-09677) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09677) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2023-08-04 |