| NPI | 1619461399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 060727) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: NY 060727) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-01-29 |