| NPI | 1023166725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN27369) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 050666) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2024-01-05 |