| NPI | 1992934780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5707) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5707) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5707) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 5707) | |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: AL 5707) | |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |