| NPI | 1760963904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 36189) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: AL Notyet) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-08-26 |
| Last Update Date | 2021-03-23 |