| NPI | 1932844149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 108719) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA DL15243) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2025-06-17 |