| NPI | 1073615415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 12935) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN5944) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-08 |