| NPI | 1164554416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN28312) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 04914302) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2024-03-08 |