| NPI | 1992952162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052917-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 9600) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2014-01-27 |