| NPI | 1255606257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 061583-01) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CO 8842) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2021-01-29 |