| NPI | 1730632266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: NH 04929) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: ME FDN16) |
| 1223P0300X Dentist Periodontics (Licence: ME DEN4808) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ZZ A29800) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2024-04-01 |