| NPI | 1427114149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 14648) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WI 5515) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-10-01 |