| NPI | 1013926377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 17709) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 2579) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2011-04-13 |