| NPI | 1811578339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA DDS-09986) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D011113) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2022-07-29 |