| NPI | 1043526163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055197-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 055197) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2018-01-25 |