| NPI | 1043361801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL dn16170) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: VA 0401411357) |
| 1223P0300X Dentist, Periodontics (Licence: MD 12987) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |