| NPI | 1093061202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D009063) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9756) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2016-08-04 |