| NPI | 1023305992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1001281) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 19317) |
| 122300000X Dentist (Licence: VA 0401414046) | |
| 122300000X Dentist (Licence: MD 15495) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2014-01-16 |