| NPI | 1952991978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 062523) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 13373) |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2022-07-27 |