| NPI | 1548432016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: NY 0501551) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 0501551) |
| 1223P0300X Dentist Periodontics (Licence: NY 0501551) | |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |