| NPI | 1740619691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15429) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15429) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2018-03-12 |