| NPI | 1295896074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 008851) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 049053) |
| 1223G0001X Dentist, General Practice (Licence: AZ 008851) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2025-07-22 |