| NPI | 1669645313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 2813) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 054320) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2024-03-10 |