| NPI | 1588869002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 50-051011) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23070) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2011-11-21 |