| NPI | 1225680531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 63747) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 6835) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2024-05-14 |