| NPI | 1497150668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 13815) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058415) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2024-07-16 |