| NPI | 1285193656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 061169) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CT 12440) |
| 1223G0001X Dentist, General Practice (Licence: CT 12440) | |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2020-08-12 |