| NPI | 1750613444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 056624-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010149) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2018-01-26 |