| NPI | 1851715791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D010523) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 057995) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2020-05-01 |