| NPI | 1942457080 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: NE 6793)  | 
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: IA 08450)  | 
| Enumeration Date | 2008-08-20 | 
| Last Update Date | 2008-08-20 |