| NPI | 1962661728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: NY 051887) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NY 051887) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2024-03-11 |