| 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 |