| NPI | 1487987988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL dn18891) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA ds037482) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2019-03-07 |