| NPI | 1932495900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2015040200) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14974) |
| 1223G0001X Dentist, General Practice (Licence: MA DL11248) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2016-07-06 |