| NPI | 1982693230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 042510-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 042510) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2010-07-22 |