| NPI | 1801993530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 16218) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052600-1) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 052600) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2020-11-17 |