| NPI | 1902916307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 050514-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 050514-1) |
| 1223X2210X Dentist, Orofacial Pain (Licence: NY 050514-1) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-03-07 |