| NPI | 1841697729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN21681) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001466) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2016-04-13 |