| NPI | 1184750929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 13385) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401411166) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-12-12 |