| NPI | 1447817382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 061403) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1858775) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2022-07-27 |