| NPI | 1013395359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MA DN14212944) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: CT 11808) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2023-03-27 |