| NPI | 1952046955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1859472) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI DEN03610) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-10-17 |