| NPI | 1548543770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN19498) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413337) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2018-02-28 |