| NPI | 1851551295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054118-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS037497) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2012-05-18 |