| NPI | 1619007929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 041709) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 350219) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2012-07-13 |