| NPI | 1457645202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 056249-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001086) |
| 122300000X Dentist (Licence: MI 2901020509) | |
| 122300000X Dentist (Licence: MD 14902) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2012-10-11 |