| NPI | 1699903351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10456) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026991) |
| 122300000X Dentist (Licence: NY 055358) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-01-18 |