| NPI | 1205012648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 12866) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 12866) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2009-04-23 |