NPI | 1508451303 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 000149-01) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MD LL879) |
Enumeration Date | 2021-03-03 |
Last Update Date | 2025-01-23 |