| NPI | 1497112395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: NY 058309) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 058309) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |