| NPI | 1518140144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 50503) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 54845) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2015-06-23 |