NPI | 1811576507 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 063414) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI02876900) |
1223E0200X Dentist, Endodontics (Licence: CT 13048) | |
Enumeration Date | 2021-04-07 |
Last Update Date | 2025-02-15 |