| NPI | 1982984993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 10719) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 6125) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2013-12-12 |