| NPI | 1487989992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 47303) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ 22D102424300) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |