| NPI | 1417153370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 053963-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 053963-1) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2015-02-19 |