| NPI | 1538812540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 063795-01) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2024-10-24 |