| NPI | 1700243235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 059712-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 12245) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2018-09-05 |