| NPI | 1982868584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AL 5640) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5640) |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2012-11-20 |