| NPI | 1326378365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413281) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 30287) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2013-05-08 |