| NPI | 1124685284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 061186) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2024-09-24 |