| NPI | 1134181035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 8306) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 4056) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2012-03-12 |