| NPI | 1548522931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 6799018-9921) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL dn0014582) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |