| NPI | 1053860924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DTP639) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: FL DTP639) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-03 |