| NPI | 1265637193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN 21863) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 053091-1) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2016-07-28 |