| NPI | 1649627373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 059185) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NY 001458) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2025-02-11 |