| NPI | 1386760304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 054306) |
| Additional Taxonomies | 122300000X Dentist (Licence: DE G1-0001171) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2018-10-02 |