| NPI | 1831241116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401008950) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: VA 0401008950) |
| 1223P0300X Dentist, Periodontics (Licence: MD 12197) | |
| 1223P0300X Dentist, Periodontics (Licence: DC 5890) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |