| NPI | 1598649519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY d-00121) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI03113400) |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2026-01-19 |