| NPI | 1669964649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 061678) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN015646) |
| 1223G0001X Dentist, General Practice (Licence: IL 019034179) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-09-12 |