| NPI | 1346876604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 063044) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 12952) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2023-05-31 |