| NPI | 1477945434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 058396) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 20891) |
| 122300000X Dentist (Licence: CT 011239) | |
| Enumeration Date | 2015-02-28 |
| Last Update Date | 2023-12-28 |