| NPI | 1366878696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN21649) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02534600) |
| 122300000X Dentist (Licence: NY 057025-1) | |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2017-03-27 |