| NPI | 1689682684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 0493291) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ DI020208) |
| 1223P0300X Dentist, Periodontics (Licence: CO 9118) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2023-06-20 |