| NPI | 1508192014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401412563) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL HAD12) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2016-03-14 |