| NPI | 1588863328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 6482-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D12324) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2014-11-18 |