| NPI | 1437401619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6271) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19585) |
| 122300000X Dentist (Licence: NY 056092) | |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2014-10-07 |