| NPI | 1386182277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VT 0160133869) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 065125) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2026-06-04 |