| NPI | 1164777173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401413652) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15070) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2016-02-02 |