| NPI | 1154847044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 061691) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 11840) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2021-08-23 |