| NPI | 1619236965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 16099) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401414043) |
| 1223G0001X Dentist, General Practice (Licence: NY 50056823) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2015-11-18 |