| NPI | 1639785223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 061872) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 105535) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2021-12-09 |