| NPI | 1124785076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 063496-01) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN122489) |
| Enumeration Date | 2021-11-25 |
| Last Update Date | 2024-09-06 |