| NPI | 1114141728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15383) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 049558) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2015-04-17 |