| NPI | 1093870065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 0600971) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 55282) |
| 1223G0001X Dentist General Practice (Licence: NV 5116) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-03-12 |