| NPI | 1831712892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN25518) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DRPM2195) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2022-04-06 |