| NPI | 1962855866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA Dn1857652) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02776900) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2024-08-13 |