| NPI | 1841954278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401418272) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859246) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2024-03-19 |