| NPI | 1821349366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413778) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001161) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2013-06-21 |