| NPI | 1003042748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410611) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 13049) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2009-06-09 |