| NPI | 1952781908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 058687-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058687-01) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2021-03-17 |