| NPI | 1043294945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 7954) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 7954) |
| 1223D0001X Dentist, Dental Public Health (Licence: KY 7954) | |
| Enumeration Date | 2005-12-04 |
| Last Update Date | 2014-06-23 |