| NPI | 1972293520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7588) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN.00205599) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2025-03-19 |