| NPI | 1669677324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: HI DT2298) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN013529) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2007-08-07 |