| NPI | 1346234853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN19289) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052291) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-10-16 |