| NPI | 1073992442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 064907) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856967) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2026-02-27 |