| NPI | 1255533212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 054148) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21409) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2025-03-10 |