| NPI | 1891947347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 055407) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY P63953) |
| 1223G0001X Dentist, General Practice (Licence: TX 24368) | |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2013-01-15 |