| NPI | 1982167698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 063072) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02808000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-01-02 |