| NPI | 1134414030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 062009) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA dn1855638) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2024-04-09 |