| NPI | 1669887444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 058039) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 058039) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2020-06-26 |