| NPI | 1356435077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MA 14113) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: MI 12010332A) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-07-30 |