| NPI | 1336450287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401414280) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 10376) |
| 122300000X Dentist (Licence: MA DN1855464) | |
| 122300000X Dentist (Licence: TX 27725) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2014-01-29 |