| NPI | 1659938397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 060281-1) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: NY 060281-1) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |