| NPI | 1215395959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN22374) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058873) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2023-01-16 |