| NPI | 1326121120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 21817) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052776) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-03-07 |