| NPI | 1467686469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 14772) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 055360) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2013-09-04 |