| NPI | 1952758419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: NY 060424-01) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: CT 12562) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2019-08-15 |