| NPI | 1033982590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: NY 000146) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 000146) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |