| NPI | 1649573759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 10315) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN5106) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2010-12-10 |