| NPI | 1396840666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD LL503) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 8464) |
| 122300000X Dentist (Licence: WV 3630) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |