| NPI | 1588952998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 010582) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 10582) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2013-06-18 |