| NPI | 1861741464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY Limited NY License) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 1223S0112X) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY limted) | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2021-08-10 |