| NPI | 1265971113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 06088901) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN22729) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2024-01-13 |