| NPI | 1386837466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052904-3) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052904) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2020-01-16 |