| NPI | 1053401638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 4646) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 4646T) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-07-29 |