| NPI | 1023661261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 063007) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11811) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2023-03-05 |