| NPI | 1124450283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN20248) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DRP1233) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2014-10-20 |