| NPI | 1912147471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30364) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02389600) |
| 1223G0001X Dentist, General Practice (Licence: NY 054298-1) | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2019-04-25 |