| NPI | 1073986345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 6231) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 6570) |
| Enumeration Date | 2015-11-08 |
| Last Update Date | 2016-06-02 |