| NPI | 1356303267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 045287-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM dd3327) |
| 122300000X Dentist (Licence: TX 25760) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2014-03-05 |