| NPI | 1780644153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411412) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13697) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2007-07-08 |