| NPI | 1528224458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 31663) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 50 053980) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2019-08-13 |