| NPI | 1982830717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN18676) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN18676) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2015-08-12 |