| NPI | 1417026196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 048533) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 048533-1) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2016-04-19 |