| NPI | 1598995623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 08667) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027995) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2010-02-10 |