| NPI | 1073704482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN16663) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 052964) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2008-06-18 |