| NPI | 1417657578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 18576) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 064990) |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2026-05-10 |