| NPI | 1740453240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 3526-09) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 5875) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2012-03-20 |