| NPI | 1912298662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: NY 056628) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: NY 0566281) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2022-07-21 |