| NPI | 1427409267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 065406) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042635) |
| 1223G0001X Dentist, General Practice (Licence: SD D1451) | |
| 122300000X Dentist (Licence: IA DDS-09299) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2026-09-09 |