| NPI | 1225723752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13924) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 064241) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2024-09-04 |