| NPI | 1144312208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053505-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 18567) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2017-09-12 |