| NPI | 1801448196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IA FAC-40209) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 14152) |
| 1223G0001X Dentist, General Practice (Licence: MA 14905) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2022-08-01 |