| NPI | 1598320681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24572) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 06160501) |
| Enumeration Date | 2019-05-05 |
| Last Update Date | 2025-11-04 |