| NPI | 1114215308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 000027-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 27) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2023-07-06 |