| NPI | 1740747583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA DDS-09682) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 09682) |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2021-07-23 |