| NPI | 1700298676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NY 060235) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 11636) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2019-06-20 |