| NPI | 1366658817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 048029-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D11756) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-03-27 |