| NPI | 1386866366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VT 0160105895) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13268) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-09-23 |