| NPI | 1053573436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: SC 4680) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 150669) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2011-08-17 |