| NPI | 1073735254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 045454-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 008096) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2012-02-06 |