| NPI | 1801939111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 0023061) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02061600) |
| 122300000X Dentist (Licence: NY 048641) | |
| 1223G0001X Dentist, General Practice (Licence: TX 0023061) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2011-01-27 |