| NPI | 1841796794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 063161-01) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI02946800) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2026010387) | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2026-07-06 |