| NPI | 1336581545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 50056806) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 056806) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2024-06-20 |