| NPI | 1093099830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2011015329) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.028859) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2012-08-27 |