| NPI | 1780064287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 058547) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058547) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2025-07-16 |