NPI | 1821309543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VT 016.0104972) |
Additional Taxonomies | 122300000X Dentist (Licence: NY NYS 055499) |
Enumeration Date | 2010-06-28 |
Last Update Date | 2014-09-09 |