| NPI | 1962960039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS110835) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1858964) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2025-03-13 |