| NPI | 1578168555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 062710) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24576) |
| 122300000X Dentist (Licence: NJ 22DI02799700) | |
| 122300000X Dentist (Licence: NY 062710) | |
| 1223P0700X Dentist, Prosthodontics (Licence: FL DN2476) | |
| 1223P0700X Dentist, Prosthodontics (Licence: NJ 22DI02799700) | |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2025-01-14 |