| NPI | 1073937538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414563) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15584) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2015-09-08 |