| NPI | 1770777104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 008653) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CT 008653) |
| 1223G0001X Dentist, General Practice (Licence: CT 008653) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2016-04-07 |