| NPI | 1326320037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 1855836) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 60301056) |
| 122300000X Dentist (Licence: RI 03154) | |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2012-11-13 |