| NPI | 1841963121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 063974) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA DN1859133) |
| 1223P0300X Dentist, Periodontics (Licence: NJ 22DI03045700) | |
| Enumeration Date | 2021-07-31 |
| Last Update Date | 2025-02-07 |