| NPI | 1770922478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2013016371) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2023-08-08 |