| NPI | 1487968467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN22253) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 055835) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2023-03-21 |