| NPI | 1417070038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: MI 2901019501) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019501) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2014-03-14 |