| NPI | 1740341254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001066) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 053078-1) |
| 122300000X Dentist (Licence: FL DN18850) | |
| 122300000X Dentist (Licence: NC 9040) | |
| 122300000X Dentist (Licence: VA 0401413124) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2015-08-12 |