| NPI | 1730178310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 14158) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 043069) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2010-06-03 |