| NPI | 1740535400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL C15954) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.029132) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2015-01-26 |