| NPI | 1811450083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 061648) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ 22DI02821200) |
| 1223P0700X Dentist Prosthodontics (Licence: NY 061648) | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2023-05-09 |