| NPI | 1245478189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 054509) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02471000) |
| 122300000X Dentist (Licence: WV 4665) | |
| 122300000X Dentist (Licence: CT 013595) | |
| 122300000X Dentist (Licence: CA DDS60803) | |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2023-11-30 |