| NPI | 1760068001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN2000281) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 062439) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401417914) | |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2023-08-16 |