| NPI | 1316697808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 065416-01) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN122836) |
| 122300000X Dentist (Licence: TN 12066) | |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2026-07-30 |