| NPI | 1033477229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 056825-1) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 056825-1) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2013-08-21 |