| NPI | 1023227642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052174) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 27143) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2026-05-06 |