| NPI | 1740345511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401413958) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: AZ D5380) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-05-18 |