| NPI | 1417578444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 062172) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25891) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2025-06-25 |