| NPI | 1922437383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VT 0160105680) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0442000199) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2014-08-06 |