| NPI | 1659915791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: NY 063099) |
| Additional Taxonomies | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: IL 019032976) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2024-03-05 |