| NPI | 1689294894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 064516) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DE G1-11489) |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2026-09-23 |