| NPI | 1326326265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413783) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855674) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2013-12-01 |