| NPI | 1962506428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401410771) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN 13012) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2007-07-08 |