| NPI | 1922129600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL HAD62) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 043893-1) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2015-02-06 |