| NPI | 1376030296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OR D11684) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: MA DN1858414) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2022-12-22 |