| NPI | 1255561908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401412543) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN100023) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |