| NPI | 1194880633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 14079) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401411596) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2008-02-26 |