| NPI | 1144489337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: NY 051707) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 051707) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2023-01-05 |