| NPI | 1942254016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 051000) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: HI CSDT-111-0) |
| Enumeration Date | 2006-05-21 |
| Last Update Date | 2023-04-20 |