| NPI | 1669602405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5672) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5672) |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: AL 5672) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5672) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL 5672) | |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2014-07-30 |