| NPI | 1336352236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 8615) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16168) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2018-11-09 |