| NPI | 1376602235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 4688T) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NV 4688T) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |