| NPI | 1225370216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10980) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 10980) |
| 122300000X Dentist (Licence: NY 057537) | |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2025-12-17 |