| NPI | 1801586391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2901601763) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901601763APP23) |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-06-19 |