| NPI | 1144452004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9453) |
| Additional Taxonomies | 122300000X Dentist (Licence: ID D4251) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2011-06-10 |