| NPI | 1639329295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health (Licence: NC 8878) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 6487273) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2012-02-24 |