| NPI | 1356101240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL101109) |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2025-08-06 |