| NPI | 1558856872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 061048) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CT 12773) |
| 1223G0001X Dentist General Practice (Licence: FL DN24014) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2021-05-19 |