| NPI | 1356480552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401410580) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: DC DEN1000297) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |