| NPI | 1922288653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 14254) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: DC DEN1000842) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2010-08-25 |