| NPI | 1033490941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN27852) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 055805) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2025-03-04 |