| NPI | 1619430709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 061155) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 061155) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2024-01-01 |