| NPI | 1568609386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010163) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 051676) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2022-12-26 |