| NPI | 1043563182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10499) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 010499) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2013-02-07 |