| NPI | 1376557561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: NC 6013) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 6013) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-04-23 |