| NPI | 1700626207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS045287) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 064819) |
| 122300000X Dentist (Licence: FL DN29190) | |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2025-08-04 |