| NPI | 1033831821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 062800) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24394) |
| 122300000X Dentist (Licence: FL 24394) | |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-10-12 |