| NPI | 1861020273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00204511) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DR61066857) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2023-09-07 |