| NPI | 1396811451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411605) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NC 7330) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-08-17 |