| NPI | 1164614418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9414) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DTP 484) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2017-03-24 |