| NPI | 1134271919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 7890) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: KY 7890) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2014-12-11 |