| NPI | 1861420259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 049770-1) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CT 009065) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2007-07-08 |