| NPI | 1790461358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 065081-01) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN2001569) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2026-04-25 |