| NPI | 1932361516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 08560) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 08560) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2015-01-21 |