| NPI | 1114105293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 007906) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 007906) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2013-03-13 |