| NPI | 1992150247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 059361) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 13065) |
| 1223G0001X Dentist General Practice (Licence: NJ 22DI02689400) | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2022-11-30 |