| NPI | 1982474755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS044346) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA DS044346) |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-07-12 |