| NPI | 1568608149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 62232) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY P66037) |
| 122300000X Dentist (Licence: MA DN1855247) | |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2013-03-15 |