| NPI | 1548392830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055314) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 42461) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2012-02-15 |