| NPI | 1730345661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 06583) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1002000-15) |
| 122300000X Dentist (Licence: IL 019.031931) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2019-09-25 |