| NPI | 1023325255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10727) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25703) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2012-04-11 |