| NPI | 1093409096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 065212-01) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: OH 30.027681) | |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2026-06-10 |