| NPI | 1265170468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 064453) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 13486) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2025-09-05 |