| NPI | 1245535822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 19133) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14636) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2014-10-03 |