| NPI | 1437410842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 053195) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 22172) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2012-06-01 |