| NPI | 1720397375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055215-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25776) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2010-09-30 |