| NPI | 1528420965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02756500) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1857253) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2022-02-10 |