| NPI | 1366401762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15269) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052086) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2021-08-26 |