| NPI | 1740547140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL dn20548) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 056743) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2026-04-29 |