| NPI | 1942438007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412781) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037870) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2010-09-07 |