| NPI | 1700164381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 059570) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 000051) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2020-02-24 |