| NPI | 1174666747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: DC DEN1001003) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 052768) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2023-10-01 |