| NPI | 1871794099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411470) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VT 016-0002255) |
| 1223G0001X Dentist, General Practice (Licence: MA 22337) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2015-10-08 |