| NPI | 1649709981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 061281) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: PA DS042783) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2022-07-21 |