| NPI | 1982394177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 42098) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 064174-01) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2026-05-03 |