| NPI | 1538165808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 034851-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 034851-1) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2013-02-25 |