| NPI | 1881089340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 058979) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.24804) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2019-05-22 |