| NPI | 1942723523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS044000) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10421) |
| 1223G0001X Dentist, General Practice (Licence: NM DD4955) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2024-05-07 |