| NPI | 1528138609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 046975) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY NY-046975) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2022-06-20 |