| NPI | 1255645404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 50055063) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 50055063) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2020-06-10 |