| NPI | 1992098727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VT 016.0087329) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN19319) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2015-11-11 |