| NPI | 1568772275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ D008266) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 12011552A) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2011-08-17 |