| NPI | 1316617970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 063702) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25967) |
| 122300000X Dentist (Licence: NJ 22DI02867500) | |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2024-01-03 |