| NPI | 1881203156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: WV 31823) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MI 4352000978) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2022-09-25 |