| NPI | 1003928375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN18531) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 52644) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-01-09 |