| NPI | 1821257817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053793-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 57532) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2011-01-25 |