| NPI | 1922620855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 11014) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12013707) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2025-02-12 |