| NPI | 1649610916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6685) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856475) |
| 122300000X Dentist (Licence: NE 7104) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2015-08-31 |