| NPI | 1154405819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD1938) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D4959) |
| 1223G0001X Dentist, General Practice (Licence: NE 6303) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-07-08 |