| NPI | 1609038637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 056596-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 52880) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2018-07-24 |