| NPI | 1316322092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN21743) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN21743) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DI02612400) | |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2018-07-10 |