| NPI | 1578822284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856973) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413409) |
| 122300000X Dentist (Licence: IL 019.028487) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2015-07-21 |