| NPI | 1174661813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 056248) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D8820) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2025-07-21 |