| NPI | 1104025667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN16528) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS021012L) |
| Enumeration Date | 2007-07-15 |
| Last Update Date | 2007-07-15 |