| NPI | 1013106079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 12219) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC 734005874) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |