| NPI | 1174195077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 063730) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 31991) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2025-11-08 |