| NPI | 1023107166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 6937199-9921) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 47780) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2008-08-21 |