| NPI | 1841892049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 12179) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9788) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2023-09-18 |