| NPI | 1841668548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401415011) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001541) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |