| NPI | 1871877704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-4631) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT 2476) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2015-02-20 |