| NPI | 1598174757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15991) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 21018) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2015-10-27 |