| NPI | 1194720151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 8253) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 8253) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2010-09-27 |