| NPI | 1649955337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 065007-01) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D011845) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2025-08-21 |