| NPI | 1992827786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 040763) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NY 040763) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2009-01-06 |