| NPI | 1326616319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CT 14217) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 064378) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2024-10-04 |