| NPI | 1932562295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 060217) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857293) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2020-09-22 |