| NPI | 1700381340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: VA 0401416097) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 063768) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2026-05-05 |