| 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 | 2025-04-24 |