| NPI | 1154496180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ 8107) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NE 6574) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2016-08-12 |