| NPI | 1508498684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13045) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN10000167) |
| 1223G0001X Dentist, General Practice (Licence: NY 062111) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2024-05-01 |