| NPI | 1407177470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413103) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14843) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2012-11-04 |