| NPI | 1992266373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV 7520) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA RES-30562) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2021-10-05 |