| NPI | 1619130762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 10379) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12011370A) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2011-02-10 |