| NPI | 1285497800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 110773) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN10000586) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-10-21 |