| NPI | 1881034023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401414818) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60988) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2015-08-21 |