| NPI | 1124436134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: NY 056437-1) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY CHANK2) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |