| NPI | 1477734192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 044974) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 044974) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 044974) | |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2008-07-28 |