| NPI | 1245543941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AK 1406) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6548-015) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2012-08-03 |