| NPI | 1124135892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 59018) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ dio2322900) |
| 1223G0001X Dentist, General Practice (Licence: NY 052087-1) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2016-01-04 |