| NPI | 1346817590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1859968) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA MCS01280A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2023-12-27 |