| NPI | 1013265453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 55391) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 2875) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |