| NPI | 1134653017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN10000696) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS102090) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-08-12 |