| NPI | 1821659046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN185842) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA CA107482) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2025-02-10 |