| NPI | 1487757068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 12110) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401411205) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2008-09-05 |