| NPI | 1770143711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41261) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02773900) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-07-24 |