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 |