NPI | 1265428643 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 50-050900) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55702) |
Enumeration Date | 2005-09-21 |
Last Update Date | 2011-08-26 |