| NPI | 1316113681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054191) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY P59405) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2014-07-06 |