| NPI | 1043724479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN29806) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 000085) |
| 1223P0300X Dentist, Periodontics (Licence: PA RFD000047) | |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2025-11-05 |