| NPI | 1861757940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15128) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413669) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-12 |