| NPI | 1801567144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 17689) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2023-05-15 |