| NPI | 1780702167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053362-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 053362) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2023-12-18 |