| NPI | 1346478575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401412699) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1855182) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2020-05-27 |