| NPI | 1497847891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411139) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 13823) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-11-05 |