| NPI | 1366245961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 14695) |
| Enumeration Date | 2025-03-29 |
| Last Update Date | 2026-04-03 |