| NPI | 1043820442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 063869) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002428) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2025-12-24 |