NPI | 1790983179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NY 054078) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ DI02408100) |
1223G0001X Dentist, General Practice (Licence: NY 054078) | |
Enumeration Date | 2007-07-06 |
Last Update Date | 2025-06-19 |