| NPI | 1912179235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 009886) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 053620) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2023-06-13 |