| NPI | 1851487078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 9014) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA 013022) |
| 122300000X Dentist (Licence: AZ D008580) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-06-18 |