| NPI | 1891030292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414370) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 003112) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2014-05-25 |