| NPI | 1831465293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 10529) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 50056977) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2022-01-26 |