| NPI | 1154583409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 9661) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN18749) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2015-09-24 |