| NPI | 1760897714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.025418) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 11769) |
| 122300000X Dentist (Licence: TN 10030) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2020-08-15 |