| NPI | 1861611220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 052024) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 257552) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2024-11-30 |