| NPI | 1891273249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DF11747) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: VT 016.0134035) |
| 1223P0300X Dentist, Periodontics (Licence: ME DEN4909) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-29 |
| Last Update Date | 2021-09-23 |