| NPI | 1164163937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13988) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 063278) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-03-27 |