| NPI | 1811684442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30707) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D15070) |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2025-05-27 |