| NPI | 1912409657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN23937) |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DN23937) | |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2023-05-22 |