| NPI | 1033237474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60621268) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052421) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-08-29 |