| NPI | 1649859026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 27535) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 062760) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2023-04-07 |