| NPI | 1972753861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 03683) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 055172) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2010-09-21 |