| NPI | 1295728913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 045702) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 045702) |
| Enumeration Date | 2005-08-28 |
| Last Update Date | 2020-06-06 |