| NPI | 1265728646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-4454) |
| Additional Taxonomies | 122300000X Dentist (Licence: MT 2459) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2017-10-10 |