| NPI | 1356694533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 011356) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 056129) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2018-07-20 |