| NPI | 1265626915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 2807) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 054152) |
| 1223G0001X Dentist, General Practice (Licence: PA DS037825) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2015-03-06 |