| NPI | 1255354213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D7129) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 13405) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-12-19 |