| NPI | 1407285695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60414981) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011876A) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |