| NPI | 1932803442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 064205) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 064205) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2025-03-20 |