| NPI | 1942539762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 057012) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 57012) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2023-07-07 |