| NPI | 1316181803 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 17874) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 051649) | 
| Enumeration Date | 2009-04-28 | 
| Last Update Date | 2009-04-28 |