| NPI | 1740257039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411243) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 047961) |
| Enumeration Date | 2006-03-05 |
| Last Update Date | 2013-12-17 |