| NPI | 1992883821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401412117) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22686) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-09-02 |