| NPI | 1982835948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055895) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401412577) |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2022-07-21 |