| NPI | 1962147280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC DGD.10704) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN27663) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DRPM2445) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2024-02-29 |