| NPI | 1598450686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 064040) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 064040) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2024-08-18 |