| NPI | 1871580423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8245) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401410742) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2013-10-05 |