| NPI | 1457784472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC DGD.8726 GD) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 10146) |
| 122300000X Dentist (Licence: PA Ds040255) | |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2016-06-15 |