| NPI | 1073894606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15284) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001087) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2019-08-09 |