| NPI | 1588017990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 061612) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 061612) |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DN21931) | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-02-24 |