| NPI | 1962412114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 052865) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 052865) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-06-07 |