| NPI | 1134435340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010287) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 055049) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2010-08-25 |