| NPI | 1710004031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 8115) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 1160) |
| 122300000X Dentist (Licence: SD M998) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2013-06-27 |