| NPI | 1124289251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN17971) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 17971) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2017-01-21 |