| NPI | 1598992257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WV 3873) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 14515) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2011-08-12 |