| NPI | 1184889917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN19141) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN013777) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2012-07-30 |