| NPI | 1982849824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 8011) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC 4060) |
| 122300000X Dentist (Licence: VA 0401008554) | |
| Enumeration Date | 2008-12-06 |
| Last Update Date | 2013-04-17 |