| NPI | 1508495581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 062201-01) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN2000494) |
| 122300000X Dentist (Licence: VA 0401417310) | |
| 122300000X Dentist (Licence: MD 19101) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-01-13 |