| NPI | 1437462140 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN19086) | 
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19086) | 
| Enumeration Date | 2010-07-22 | 
| Last Update Date | 2020-05-01 |