| NPI | 1861694226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY NY054327-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 10428) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2009-07-29 |