| NPI | 1225147168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN 9235) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 051745-1) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-01-29 |