| NPI | 1174844450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9549) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6078) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2014-10-16 |