| NPI | 1578651121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050949) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 050949-1) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-02-24 |